ABSTRACT NUMBER: ESOC2026A1127 BRIDGING GAPS IN STROKE CARE: THE FREDERICK FOUNDATION'S INTERNATIONAL CLINICAL OBSERVERSHIP APPROACH

Abstract Background and aims Stroke outcomes in low-and-middle-resource settings are constrained by system-level gaps, including delayed triage, limited neuroimaging access, restricted reperfusion therapies, and absence of standardised care pathways. International observership programmes may enhance quality improvement (QI) by promoting systems thinking, multidisciplinary collaboration and local implementation capacity. The Frederick Foundation aims to explore whether a structured international stroke multidisciplinary team (MDT) observership can address service gaps and support actionable QI intentions. Methods A stroke MDT from University College Hospital, Ibadan in Nigeria, including an emergency physician, neurologists, residents, nurses and a physiotherapist completed structured surveys before and after an observership at the Royal Berkshire Hospital in the UK. Pre-observership surveys assessed clinician confidence, learning priorities and service challenges. Post-observership surveys evaluated learning attainment, perceived value and intended service changes. Responses were thematically analysed and mapped across key stroke pathway domains. Results Pre-observership findings revealed moderate MDT confidence but significant system-level barriers: limited neuroimaging, thrombolysis access, workforce shortages, poor MDT coordination, delayed presentation and lack of pre-hospital pathways. Learning priorities included hyperacute workflows, imaging interpretation, rehabilitation and standardised protocols. Post-observership evaluations rated the experience highly, with objectives met across participants. Reported gains included exposure to coordinated MDT-care, hyperacute and reperfusion workflows, structured imaging assessment, standardised outcome measures and organised discharge-planning. The MDT-observers identified feasible, context-adapted QI-actions such as MDT-led care models, emergency triage, imaging protocols and locally implementable standard operating procedures. Conclusions Structured international stroke-MDT observerships can align identified service gaps with actionable QI-strategies, supporting scalability in resource-limited settings, enabling evaluation of impacts on patient mortality and morbidity. Conflict of interest Nothing to disclose